Clinical Expertise. Demonstrated Results.
Prescription drug costs continue to rise and have become a larger percentage of total health care expenditures for the workers’ compensation and auto casualty markets. In order to control rising drug costs, payers have partnered with pharmacy benefit managers (PBMs). Demonstrating measureable expenditure savings demands more than just a basic re-pricing of pharmacy claims. By breaking the management process into components and treating each as a cost-saving process, Cypress Care’s unique approach yields far greater savings and offers greater support, flexibility and reliability than programs dependent entirely on price.
Cypress Care’s pharmacy program is designed to manage prescription costs and enforce approved formulary guidelines while providing claimants with convenient, hassle-free access to their medications and simplifying the job of claim professionals.
Our pharmacy benefit management program includes the following components:
Roll over circles for details on each component.
Cypress Care’s approach to pharmacy benefit management is based on the use of technology, proven processes and comprehensive clinical management programs to address five key factors:
- Drug selection by the prescribing physician
- Identification of newer drugs without generic substitution opportunities
- Misuse and overuse of certain types of drugs
- High volume of prescriptions
- Multi-pharmacy/multi-physician involvement
Cypress Care ensures claimants are taking the proper medication and prevents inappropriate or non-compensable medication from being dispensed. By monitoring physician behavior and integrating physician reviews into the prior authorization process, we ensure treatment plans are appropriate and address the needs of high dollar claimants – all while maintaining our focus on cost savings for our customers.
Contact a Cypress Care representative to learn more about our Pharmacy Benefit Management program.
